Health Tips

August 2020 Reopening Presentation

CDC Information

• Operational Guidance for K-12 Schools
• COVID-19 Guidance (CDC)

COVID-19 At-Home Test Kit Expiration Date Information

• US Food and Drug Administration List of COVID-19 At-Home Tests
• CareStart - Lot Numbers and Expiration Dates
• iHealth Labs - Lot Numbers and Expiration Dates
• FlowFlex - Lot Numbers and Expiration Dates

Erie County Department of Health Vaccination Information

• https://www3.erie.gov/health/immunization-clinics

Enterovirus produces symptoms much like the common cold: fever, runny nose, sneezing, and coughing with some infected individuals experiencing skin rash, mouth blisters, and muscle aches. Not all people who get EV D68 will have severe illness but if your child shows signs of difficulty breathing or severe wheezing with a respiratory illness, take your child to be evaluated immediately.

There is no vaccine to prevent Enterovirus and no specific treatment. This is a good time to remind your children of the importance of prevention measures to minimize the spread of the virus, including the following:

• Wash hands often with soap and water for 20 seconds
• Avoid touching of eyes, nose and mouth with unwashed hands
• Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick
• Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick
• Use the same precautions used to prevent the spread of influenza

If your child becomes ill with a fresh upper respiratory illness, please consult with your child’s healthcare provider. It may also be necessary to keep your child at home to rest and recover. 

For more information about Enterovirus, please visit the Centers for Disease Control (CDC) site: CDC - Enterovirus D68
 

Facts About Head Lice

• Head lice are VERY common in children ages 3 to 12 years and are found more commonly in girls than boys.
• Having head lice doesn’t equal poor hygiene practices.
• Head lice have existed for many centuries and do NOT spread disease, although they are a major nuisance.
• Live lice can only live one to two days when not on an individual’s head.
• Live lice CRAWL, they cannot jump or fly.
• A nit is simply a louse’s egg; the egg must hatch, which takes about 10 days, in order to produce a live louse. Nits found more than ¼ inch down the hair shaft are usually considered non-viable (they will not hatch). 
• Direct head-to-head contact with an infested individual is the most common way to get head lice. Less likely is contracting head lice through sharing personal items such as combs, brushes, headphones, and hats.
• Lice can be transmitted easily between family members, close play mates, during sleep overs, and at camps.
• Seeking prompt and proper treatment is essential in eliminating an active case of head lice. 
• Head lice are not as contagious as you may think…a child typically has head lice for 4 to 6 weeks before it is identified (this is the length of time it takes for a person to develop a sensitivity to the salvia of a head louse; this sensitivity is what causes the head itching and scratching). After 4 to 6 weeks of an individual being infested with head lice, one would expect that the entire classroom would have head lice and this is rarely the case. It is much easier to contract a common cold than it is to get head lice.

Helpful Tips to Prevent the Spread of Head Lice

• Become familiar with the signs and symptoms to look for in a child with head lice (i.e. a child continuously scratching their head, sores on a child’s head caused by scratching, the presence of live lice and nits close to the child’s scalp).
• Check your child’s head daily for live lice and nits. Live lice are usually few in number, can move quickly and are hard to detect. The most common areas to find lice are behind the ears, at the crown of the head, and at the base of the neck. Consult with the school nurse as to how to properly check your child’s head and to review exactly what a head louse and a nit look like. A louse is about the size of a sesame seed and is tan to brownish-red in color.  A nit is small, yellow or gray-white in color, and oval-shaped. Nits are not easily removed from the hair shaft, they are usually “glued” tightly which is unlike dandruff, gel, or hairspray remnants that can easily be removed.
• Remind your child not to share personal items such as hats, combs/brushes, headphones, and scarves.
• Encourage your child to do their best to avoid direct head to head contact with other children (this is the most common way head lice are spread from one individual to another).
• Consider having your child with long hair wear their hair back in a pony-tail.
• Place hats, scarves, gloves in a child’s zipped back pack or in the sleeves of a child’s jacket as this can be helpful in preventing the spread of head lice.

Head Lice Treatment Measures

• Consult with your child’s health care provider for treatment options/recommendations as soon as head lice have been identified on your child’s head. Following product package instructions and your doctor’s recommendations are a must.
• Notify the school nurse if your child has been treated for head lice. A child who has active head lice should be properly treated before they return to school and should see the school nurse daily for head checks.
• Vacuum all rugs, carpets, car upholstery, and furniture daily for 10 days; starting with the day your child is identified with and treated for head lice through the second head lice treatment (typically given 7 to 10 days after the first treatment).
• Wash all bedding, clothes, hats, and scarves on a hot cycle and dry clothes on a high heat setting for at least 30 minutes. This should be done after head lice have been identified on your child (one time should be sufficient unless you are still seeing active live lice).
• Wash all combs, brushes, and hair accessories in hot soapy water or soak in rubbing alcohol or Lysol for one hour.
• All non-washable items can be placed in a sealed plastic bag for 2 weeks.
• Check your child’s head daily at home for the presence of live lice and nits. Fine comb the hair and remove all nits found. Let the school nurse know if you discover any live lice and/or nits.
• If multiple cases of head lice have been detected in your child’s classroom, we would ask that you send in a plastic bag for your child’s belongings to be stored in during the school day. 

References

• Centers for Disease Control, Head Lice Infestation Fact Sheet. 11/29/10
• Devore, Cynthia D. Ask SNN Q&A. School Nurse News. November 2010.
• Frankowski, B.L., Bocchini, J.A., and Council of School Health and Committee on Infectious Diseases. Head Lice. July 26, 2010. Pediatrics: Official Journal of the American Academy of Pediatrics.
• Guillebeau, P. & Van De Mark, G. A Parent’s Guide to the Nitty-Gritty about Head Lice. The University of Georgia. Cooperative Extension Service; College of Agricultural and Environmental Sciences.
• Pontius, D.J. NASN School Nurse. Hats off to Success Changing Head Lice Policy, Table 1. Lice 101: Everything You Really Didn’t Want to Know About Lice! November 2011

What is Influenza (flu)?  

The flu is a contagious respiratory illness caused by viruses, which can be mild to severe, sometimes requiring hospitalization. Up to 20% of the population gets the flu.

What are the symptoms? 

Symptoms of the flu may include high fever, headache, extreme tiredness, dry cough, sore throat, runny nose, muscle aches, stomach symptoms, such as nausea, vomiting, and diarrhea.

What are possible complications? 

Some complications of the flu include pneumonia, dehydration, sinus or ear infections, and worsening of some conditions such as asthma and diabetes.

How does the flu spread? 

The flu is spread by respiratory droplets from coughing and sneezing, or touching surfaces contaminated with viruses and then touching the mouth or nose.  People are contagious beginning one day before getting symptoms and over a week after getting sick. 

How can I help prevent the spread of the flu? 

Everyone should practice proper hand hygiene, cover all coughs into the crux of the arm so as to decrease contamination to the hands, clean environmental surfaces regularly. 

How is a cold different from the flu?  

Differences between a cold and the flu vary.  In general, the flu is worse than a cold and symptoms such as fever, body aches, extreme tiredness and dry cough are more common and intense. Colds tend to develop slowly, more likely to have a runny or stuffy nose and usually do not develop into serious symptoms.

How can I protect myself from the flu? 

The best way to prevent the flu is by getting a vaccination every year.

Who should get a flu vaccine? 

Flu vaccine should be given to all persons, including school-aged children.

Those at greatest risk for complications of the flu include those who are:

• Under 6 months of age to 19 years of age
• Over age 50, those on long-term aspirin therapy
• Pregnant women
• Individuals with weakened immune system
• Individuals with chronic medical conditions
• Health care workers
• Healthy household contacts, caregivers of persons with chronic medical conditions

A full list of recommendations is available at: https://www.health.ny.gov/diseases/communicable/influenza/fact_sheet.htm

Quick Tips for Staying Healthy: Prevention is Key!

• Get your yearly Flu vaccine
• Cover all coughs and sneezes either with the crux of your arm or with a tissue
• Throw tissues out immediately after use
•  Wash your hands with soap & water frequently, sing the Happy Birthday song twice while washing
• Use hand sanitizer when no soap is available
• Keep hands away from your face including your eyes, nose, and mouth
• Get plenty of sleep every night, children require at least 10 hours per night
• Increase your daily intake of fruits and vegetables
• Stay physically active and physically fit 

Influenza Informational Resources:

• CDC Everyday Preventive Actions - Flu

When to Keep a Child with Illness Home During the Cold and Flu Season

It can be difficult for a parent to decide whether to send children to school when they wake up with early symptoms of an illness or complaints that they do not feel well. Consider the following guidelines when deciding to send your child to school. 

When to Send Your Child to School

In general, during cold and flu season, unless your child is significantly ill, it is okay to send them to school where they have already been exposed to the same germs and where they are less likely to expose other more vulnerable people, like the very young or very old, to routine bouts of cold and flu.  It is important to remind and show your children to discard used tissues promptly, not to share personal items, to cover their mouths when they cough or sneeze, to keep their hands away from their face, and to wash hands thoroughly and often with soap and warm water. Suggest that they silently sing the Happy Birthday song twice while washing their hands.  If you send your child to school even though you suspect there is significant illness, as described above, please call the school nurse to provide her/him with phone numbers where you can be reached that day should your child become more ill and require early dismissal.

When to Keep Your Child Home

There are some situations in which it is best to keep your child home for a day to rest or to arrange for an appointment with your health care provider.  If you know your child is running a fever, it is best to allow them to remain at home in bed and take their medications until they are off all medicines and ready to learn for a full day in a classroom. If there is a pattern of your child’s asking to stay home from school, especially if they are falling behind or appear anxious by the thought of attending school, or if there does not appear to be any obvious physical symptoms, it may be a good idea to contact your school nurse and your health care provider to discuss your concerns.  Remember, whenever you keep your child home from school, please call the school nurse or attendance office before the start of the school day and leave a message that your child will be absent.

The Following Are A Few Such Situations That Warrant Watching and Possibly Conferring with Your Health Care Provider: 

1.     Persistent fever higher than 100.4° orally, including a fever that requires control with medication.

2.     Child is too sleepy or ill from an illness, like vomiting and/or diarrhea, to profit from sitting in class all day.

3.     Significant cough that makes a child feel uncomfortable or disrupts the class.

4.     Sore throat that is severe, accompanied by fever and/or feeling ill, that persists longer than 48 hours, OR after known exposure to a confirmed case of Streptococcal throat infection.

5.     Honey-crusted sores around the nose or mouth or rash on other body parts that might be impetigo; OR a rash in various stages including boils, sores and bumps that may be chicken pox; OR a significant rash accompanied by other symptoms of illness such as fever.

6.     Red, runny eyes that distract the child from learning.

7.     Large amount of discolored nasal discharge, especially if accompanied by facial pain or headache.

8.     Severe ear pain or drainage from the ear.

9.     Severe headache, especially if accompanied by fever.

10.  Any condition that you think may be serious or contagious to others.

A Note of Caution in Children

Health care professionals strongly advise against ever using aspirin or aspirin-containing products in children without the expressed permission of the child’s medical provider due to an association to REYES SYNDROME.  Reyes Syndrome is a very serious disease that develops as one is getting over a viral illness that targets the liver and brain and is difficult to diagnose (should be suspected in anyone who vomits repeatedly about 3 to 5 days after the onset of the illness) and should be monitored by the primary medical provider.  It is best to read the labels of any over-the-counter medications/products for aspirin-containing ingredients (salicylate compounds).  Some common items (also applies to generic brands): Alka Seltzer, Excedrin, Maalox, Pamprin, topical skin products (acne treatments), muscle and joint creams, wart removers, and others.  

For families planning to travel internationally over the summer months, now is an excellent time to review your families’ immunization status with your private health care provider to make sure you and your family are sufficiently protected against diseases such as polio, measles, mumps and pertussis. Preventable diseases once thought to be eliminated are resurfacing, some even reaching epidemic proportions. 

The Center for Disease Control (CDC) and the World Health Organization (WHO) have issued traveler guidelines that you may want to review and discuss with your private health care provider particularly if you are planning to travel to any of the following locations: Pakistan, Cameroon, Syria, Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia, or Nigeria. 

Centers for Disease Control and Prevention - CDC

• Travelers' Health

Travelers to polio-affected areas should review with their health care provider the following guidance prior to travel: Chapter 4 Travel - Related Infectious Diseases Poliomyelitis

Travelers also may be impacted by Polio Vaccination Recommendations in countries with ongoing poliovirus transmission.  Your primary care provider should be able to address these recommendations with you.  In addition, it has been recommended that travelers to or from all 10 countries should be given an International Certificate of Vaccination or Prophylaxis: International Certificate of Vaccination or Prophylaxis (ICVP)

For more detailed information regarding polio, measles, mumps, and pertussis, please visit the CDC website by using the following links:

• Polio                  http://www.cdc.gov/polio/
• Measles            http://www.cdc.gov/measles/about/index.html 
• Mumps             http://www.cdc.gov/mumps/index.html
• Pertussis          http://www.cdc.gov/pertussis/

What is Measles? 

Measles is a highly contagious and very serious respiratory disease caused by a virus. 

What are the symptoms? 

Measles symptoms usually appear in 10 to 12 days after exposure, but can occur as late as 18 days after exposure. Symptoms generally appear in two stages. In the first stage, which lasts two to four days, the individual may have a runny nose, cough and a slight fever. Eyes may become reddened and sensitive to light while the fever gradually rises each day, often peaking as high as 103° to 105° F. Small bluish white spots surrounded by a reddish area may also appear on the gums and inside of the cheeks. The second stage begins on the third to seventh day and consists of a red blotchy rash lasting five to six days. The rash usually begins on the face and then spreads downward and outward, reaching the hands and feet. The rash fades in the same order that it appeared, from head to extremities.

How is Measles spread?

Measles is spread through contact with nasal or throat secretions of infected people. When an infected person sneezes, coughs, or talks, droplets become airborne and are infectious. Droplets from an infected person landing on surfaces may remain active and contagious for up to 2 hours.

Who is at risk? 

Although measles is usually considered a childhood disease, it can be contracted at any age by individuals who never had the measles disease or been vaccinated. A person is considered immune from contracting measles if they have received two doses of Measles, Mumps, and Rubella (MMR) vaccine OR if they were born before January 1, 1957, OR have a history of laboratory-confirmed measles, OR have a blood test confirming immunity. Unimmunized individuals, including adults, should contact their private health care providers to check on their immunization status. Anyone who believes they might have been exposed, especially pregnant women, should contact their private health care providers.

The single best way to prevent measles is to be vaccinated. More information regarding measles can be found at: http://www.health.ny.gov/diseases/communicable/measles/fact_sheet.htm

What is Monkey Pox?

Monkey pox is a rare disease caused by infection with the monkey pox virus. Monkey pox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Monkey pox symptoms are similar to smallpox symptoms, but milder, and monkey pox is rarely fatal. Monkey pox is not related to chicken pox.

What are signs and symptoms of Monkey Pox? 

People with monkey pox get a rash that may be located on or near the genitals and could be on other areas like the hands, feet, chest, face, or mouth.

• The rash will go through several stages, including scabs, before healing
• The rash can initially look like pimples or blisters and may be painful or itchy

Other symptoms of Monkey Pox can include:

• Fever
• Chills
• Swollen lymph nodes
• Exhaustion
• Muscle aches and backache
• Headache
• Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
• Sometimes, people have flu-like symptoms before the rash
• Some people get a rash first, followed by other symptoms
• Others only experience a rash

How long do Monkey Pox symptoms last? 

Monkey pox symptoms usually start within 3 weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash 1-4 days later. Monkey pox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

How does Monkey Pox spread? 

Monkey pox can spread to anyone through close, personal, often skin-to-skin contact, including:

• Direct contact with monkey pox rash, scabs, or body fluids from a person with monkey pox
• Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkey pox
• Contact with respiratory secretions

How do you protect yourself from Monkey Pox?
1.    Avoid close, skin-to-skin contact with people who have a rash that looks like monkey pox.

• Do not touch the rash or scabs of a person with monkey pox.
• Do not have intimate contact with someone with monkey pox.

2.    Avoid contact with objects and materials that a person with monkey pox has used.

• Do not share eating utensils or cups with a person with monkey pox.
• Do not handle or touch the bedding, towels, or clothing of a person with monkey pox.

3.    Wash your hands often.

• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.

Resources – CDC and NYSDOH
For more information regarding Monkey Pox, please visit CDC and NYSDOH at:

• https://www.cdc.gov/poxvirus/monkeypox/index.html
• https://health.ny.gov/diseases/communicable/zoonoses/monkeypox/

Why is it important to protect against mosquito bites?
Mosquito bites can be more than just annoying and itchy. Mosquitoes can carry disease that can make you really sick. Protect yourself and your family when traveling. Using insect repellent is the best way to prevent diseases like Zika, dengue, and chikungunya that are spread by mosquitoes. To learn more about these diseases, visit https://www.cdc.gov/mosquitoes/.

How can I protect against mosquito bites?
Whenever possible, wear long-sleeved shirts and long pants when spending time outside. You can repel mosquitoes by using an Environmental Protection Agency (EPA)-registered insect repellent https://www.epa.gov/insect-repellents

When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women. Always follow the product label instructions, reapply repellents as directed, and consult with your family’s healthcare provider before using any of these products. If you are also applying sunscreen, apply sunscreen first and insect repellent second.

How can I control mosquitoes inside and outside my house?
When available and when indoors, use air conditioning. If air conditioning is not available, screens should be used on all windows and doors. Holes in screens need to be repaired to keep mosquitoes outside. When sleeping outdoors, sleep under a mosquito bed net. Mosquitoes lay eggs near standing water. Once a week, empty and scrub, turn over, cover, or throw out items that hold water. Some examples of such items include tires, wheelbarrows, buckets, planters, toys, pools, birdbaths, flower pots or waste containers.

How can I Protect against mosquito bites when traveling?
Please visit https://www.cdc.gov/chikungunya/pdfs/fs_mosquito_bite_prevention_travelers.pdf and CDC Travelers’ Health website to learn more about country-specific travel advice, health risks, and how to stay safe when traveling.
 

Prevent Rabies

• Teach children never to handle wild animals and animals that they do not know. "Love your own, leave other animals alone" is a good rule for children to follow.
• Wash any cut or bite from an animal with soap and water and seek medical help right away
• Stop bats from entering your homes, churches, schools and other similar areas where they might come in contact with people and pets

Be a responsible pet owner:

• Keep vaccinations current for all dogs, cats, and ferrets
• Keep your cats and ferrets inside and always watch your dogs when outside
• Call animal control to remove stray animals from your neighborhood
• Have your pets spayed or neutered

People who have frequent contact with warm-blooded animal saliva or bodily fluids, such as those who work in veterinary clinics, animal control, animal grooming or agriculture should talk to their health care provider about pre-exposure vaccination as a precaution.

Dogs, cats and domestic ferrets four months of age and older are required to be vaccinated against rabies in Erie County. ECDOH holds free rabies vaccination clinics in the spring and fall. Fall dates will be announced later this summer.

Erie County Department of Health, Rabies: https://www3.erie.gov/envhealth/rabies-vaccination-clinics-pet-health

Erie County Department of Health, Bats: http://www2.erie.gov/health/index.php?q=bats 

New York State Department of Health, How to Capture a Bat Safely (video): https://www.youtube.com/watch?v=_YhnV5WJQBA     

• Sudden Cardiac Arrest
• Sudden Cardia Arrest Tool Kit
• NYSED Memo – Sudden Cardiac Arrest

Where can ticks be found? 
You may come in contact with ticks during any activities outdoors, particularly near wooded or grassy areas. Blacklegged ticks most often live in moist, humid environments.

What do ticks look like?

 

 

 

 

How can I avoid ticks?
You can avoid ticks by avoiding tall vegetation, such as tall grass or shrubs. When hiking, walk in the center of paths or trails.

How can I repel ticks?
You can repel ticks for several hours by applying a repellent containing 20% or more of DEET on skin or clothing. Products containing 0.5% permethrin can be used to treat clothing, boots, jackets and camping or hiking gear. Product directions for application must always be followed. Avoid applying these products to your hands and face, and consult with your child’s pediatrician before use.
For tick repellent information for your pets, check with your veterinarian.

Where on the body do I look when performing daily tick inspections?
After being outside, perform a full body skin check. Bathing or showering after being outside allows for easier detection of ticks. Special attention should be paid to several areas of the body including, but not limited to:

• under the arms
• in and around the ears
• inside and around the belly button
• behind the knees
• on your head, by inspecting in and around your hair
• between the legs
• around the waist

All clothing, camping equipment, and pets should be checked for ticks. Ticks can enter the home through pets or clothing and later attach to a person’s skin. Placing clothing and blankets in the dryer on high heat will effectively kill any ticks potentially living on these items.
 
How do I safely and properly remove a tick?
If you should find a tick, stay calm and do not panic. A pair of fine-tipped tweezers can be used to safely and effectively remove a tick from the skin. Avoid using your bare hands to remove a tick. It is extremely important to remove a tick as soon as possible because the chance of contacting Lyme disease is lessened if the tick has been attached to the skin for less than 24 hours.

Steps to remove a tick:

1. Locate fine-tipped tweezers and grasp the tick with the tweezers as close to the skin surface as possible. Pull upward as steady as possible using even pressure. You want to remove all parts of the tick, including all mouth parts.
2. Place the tick in a sealed baggie or sealed container to bring to your doctor. Ticks can be sent for laboratory testing to determine the tick type and potential for disease.
3. After removing the tick, the area of the skin needs to be thoroughly washed with soap and water. Your hands should also be thoroughly washed with soap and water.
4. Always follow-up with your doctor if you should find a tick and after removal of a tick. If you experience a rash or a fever within several weeks of removing a tick, visit your doctor immediately.

 

 

 

 

 

Information adapted from the Centers for Disease Control (CDC), 5/14/2014: https://www.cdc.gov/lyme/

What is Zika Virus?
Zika virus is spread to people mainly through the bite of an infected mosquito. Currently, outbreaks are occurring in many countries and territories. All travelers are urged to practice enhanced precautions while traveling.

What are the symptoms associated with Zika Virus?
Zika virus can cause:

• Fever
• Rash
• Conjunctivitis (red/pink eyes)
• Joint pain 

Symptoms are generally mild and may last several days to a week.

Who is at risk?
Anyone who is living in or traveling to an area where Zika virus is found who has not already been infected with Zika virus is at risk for infection. However, the greatest cause for concern appears to be exposure by pregnant women due to the risk to the developing fetus. Therefore, mosquito protection would be important to those traveling to affected areas. Individuals who are pregnant or planning to become pregnant and have travel plans to these areas may want to view the Center for Disease Control link below and discuss the matter with their private physician.

What is the treatment?
No specific antiviral treatment is available for Zika virus disease. Treatment is generally supportive and can include rest and fluids.

What is the prevention?
No vaccine or prevention drug is available. The best way to prevent Zika virus infection is to:

• Avoid mosquito bites
• Use air conditioning or window and door screens when indoors
• Wear long sleeves and pants, and in consultation with your doctor, use insect repellents when outdoors

Pregnant woman should not travel to areas with risk of Zika. If you or your partner are trying to get pregnant, consider avoiding nonessential travel to areas with a CDC Zika travel notice. Talk to your doctor or other healthcare provider about your travel plans.

For more information, please visit the CDC website:

• https://www.cdc.gov/zika/